Survey finds nearly 70% of patients waiting too long for treatment

12 November 2014

A survey of ophthalmologists found that nearly 70% of patients with wet age-related macular degeneration (AMD) had to wait more than the recommended two weeks for their first sight-saving injection. Many also wait too long for follow up treatment.

The Royal College of Ophthalmologists and the Macular Society say their research shows that more resources are needed to treat elderly people with wet age-related macular degeneration (AMD).

Untreated wet AMD can rob a person of all their central vision in a few weeks leaving them unable to drive, read or recognise faces. Delayed treatment is also less effective.

More than three quarters of ophthalmologists blamed medical staff shortages for the delays and more than half said that NHS managers do not give wet AMD a high enough priority.

AMD is the biggest cause of sight loss in developed countries. Around 600,000 people in the UK have some form of the disease with nearly 200 new cases diagnosed every day. The Macular Society estimates there are around 40,000 new cases of wet AMD every year. AMD is becoming more common as society ages.

Most forms of AMD are untreatable but wet AMD can be treated with drugs, which are injected into the eye. The drugs stop the growth of abnormal blood vessels in the retina. These leak and scar the macula, the centre of the retina.

Bernie Chang, Chair of Professional Standards at The Royal College of Ophthalmologists said: “Most ophthalmic departments are finding it difficult to cope with demand for this treatment and a third are now using non-medical staff to give injections. We need a significant increase in capacity to be able to deliver services that are sufficient, as well as efficient. It is essential not to give this treatment late as vision will be lost unnecessarily.”

Bev Langton from Wem in Shropshire, has been helping her elderly mother battle to get her appointments for treatment within the timeframes recommended by her consultant. She said: “My mother is in her 90th year and has had numerous Lucentis4 injections for her wet AMD.

“The clinical care received at Shrewsbury Hospital has been excellent but there has been a constant frustration that the appointment waiting times are consistently much longer than the consultant recommends. For example, the consultant will recommend an appointment in 4 – 6 weeks, but the appointment staff arranges it for 6 – 8 weeks.

“At a recent follow up consultation, mum was told she needed another injection in around 2 weeks time. When the 2 week period was almost up, mum phoned to see when the appointment was to be. She was told, not to her surprise, that it would be another two weeks yet; twice as long as the consultant recommended.

“We seem to be constantly battling for appointments to come though according to the consultant’s recommendations. It is frustrating, and more to the point we have to question whether the constant delays have caused my mum any avoidable sight loss.”

Macular Society Chief Executive, Tony Rucinski, said: “We know many areas of the NHS are struggling but elderly people with AMD need and deserve proper care. It is devastating to lose your vision.

“These people have paid into the NHS all their lives and they have a right to expect timely treatment. There will be hundreds of thousands of patients with wet AMD in the coming years. The cost to individuals and to society of not treating them properly will be enormous.”

The survey was sent to 226 consultant ophthalmologists and received a 28% response rate. The survey suggests that there have been small improvements in some areas since a similar survey a year ago but that more clinics were reporting staff shortages.